Difficulty securing a doctor’s appointment since the start of the decade has meant there is now no question that people are perfectly happy to see a GP virtually rather than endure an interminable wait to visit their local NHS practice.
While the pandemic changed the game, in the years since digital savvy customers have welcomed the ability to see a GP at their own convenience.
Insurers and providers remain confident service and quality can be maintained as capacity concerns have mounted in the year since a provider was downgraded by the Care Quality Commission (CQC).
But industrial action by NHS GPs will inevitably see demand increase even further – meaning providers need to be clearer on the limits of this most important benefit or risk disappointing customers.
Thousands of appointments a week
“Demand for our GP services has grown tenfold in the last four years,” Dr Tom Davis, co-country manager and medical director at Livi UK, tells Health & Protection.
“We’re now booking more than 5,000 appointments per week,” Davis says.
“We have witnessed two distinct spikes – the first around the Covid-19 outbreak, and the second in the last 12 to 18 months.”
But Livi is not on its own in witnessing increased demand for its services.
Teladoc UK has seen a 36% increase in GP consultations year-on-year, rising from 68,357 in 2023 to 89,496, with the number of weekly consultations up 31% – from 1,636 to 2,230 and monthly consultations, up 42% – from 7,378 to 10,444 over the same period.
And according to HealthHero’s booking data for the period between January and August this year, it saw a 30% increase in total GP consultations on the same period last year.
Consultations between January and August last year were up 67% when compared to the same period in 2022.
Demand for these services is broad, Steve Casey, marketing director at Square Health, tells Health & Protection.
“We see a wide spectrum of customers using the service with the 26-45 age range the highest and almost a 50-50 split between males and females for digital GP consultations,” Casey says.
“Our oldest customer using the digital GP service is 96 years young.”
Convenience of service
But the fact that demand has not dropped off in the years since the pandemic is not solely down to the 9am rush to book an appointment at the local NHS GP surgery.
Oliver Jones, commercial director at National Friendly, tells Health & Protection: “We see calls in the late evening and early hours of the morning and at the weekends to coincide with GP practice out of hours, different working patterns, and flexible customer needs.”
Lottery of trying to get an appointment
Emma Wood, director of healthcare at Broadway Insurance, agrees, adding: “As we know trying to get an appointment with your GP is a bit of a lottery.
“This service is proving to be an invaluable benefit for individuals who need to access primary care.”
It is a point backed up by Keith Klintworth, managing director at VitalityHealth.
“The service’s popularity reflects both the demand that is there for GP appointments and their convenience, with 99% of our health members able to access a GP consultation within 48 hours,” Klintworth tells Health & Protection.
“Additionally, the service is completely integrated into our health insurance offering, with GPs trained to support preventative health and able to issue private prescriptions.
“Importantly, they can also refer members on for further treatment and investigations where needed, providing members with a smooth transition and access to clinical services.”
Joanna Streames, owner of Velvet Mortgage and Insure Services, tells Health & Protection she has not heard anyone say it is easy to get a GP appointment in the last six months at least, if not longer.
“In the past week alone, I’ve had a message from abroad for a client experiencing hand tremors who couldn’t get through to her GP after over an hour on hold,” she says.
“The client was feeling generally under the weather over a prolonged period, wanting to see her GP and has to wait weeks to see what’s going on.”
GP industrial action
The bad news is the situation is only likely to worsen as NHS GPs take industrial action, which includes cutting appointments.
Karla Edwards, owner of the Protection Parent, tells Health & Protection: “With the NHS GP strike limiting in-person appointments, more people are likely turning to virtual GPs to fill the gap.
“Fewer in-person slots mean more demand for remote consultations, which helps manage patient loads and cut down on waiting times,” Edwards says.
“When it comes to whether virtual GP providers can keep up with all this demand, they do have some flexibility compared to traditional GP practices.
“But if the demand grows too quickly, they might struggle with maintaining quality and keeping up with appointment requests.”
Maintaining quality of service
But Stephanie Parton-Corr, GB wellbeing lead at WTW, warns a further challenge comes in maintaining the same quality and level of service as face-to-face GP services which can prove challenging.
“Digital GPs may have concerns about missed or delayed diagnosis because of the limited information they can obtain without physical examinations,” Parton-Corr says.
“This can lead to the increased use of investigations and referrals to other services, and this is becoming evident in many private healthcare plans in the UK where we are seeing universal increases in incidence rates, predominantly around outpatient treatments and diagnostics in the UK for all employer groups across the market.”
Capacity concerns
The capacity in the sector to meet demand is also a concern for Kristian Breeze, director of healthcare at Ascend, who says this issue is now under increased scrutiny.
“While most have expanded operations, there are concerns about whether they can continue to meet growing demand, particularly as some CQC inspections suggest that quality standards may be at risk,” Breeze says.
“The Care Quality Commission itself has faced criticism for its ability to perform timely investigations, raising concerns about whether regulatory oversight is keeping pace with this growing sector.
“A recent independent review revealed significant failings at the regulator, adding further pressure on the CQC to ensure virtual health services meet necessary care standards.
“To mitigate the risk of downgrading, virtual GP providers are increasingly collaborating with insurers, implementing stringent quality controls, and investing in technology to ensure patient safety.
“However, if demand continues to outstrip supply, insurers may need to introduce usage restrictions or tiered access, offering premium services for complex cases.”
Improvements following downgrading
Axa Health’s virtual GP service Doctor Care Anywhere, is one such provider to experience downgrading by the CQC.
According to Andy McClure, marketing and propositions director at Axa Health, the service remains consistently popular.
“Pre-pandemic, the number of Doctor at Hand appointments was in the region of 17,000 per month across all customers,” McClure says.
“This is now around 55,000 per month. We saw the largest increase between 2022 and 2023 but this has slowed throughout 2024 and the figures have been consistent for some time now.
“The service we provide is equipped to deal with the level of demand we’re experiencing.”
And with the CQC facing criticism over the timeliness of its investigations, over the summer Doctor Care Anywhere told Health & Protection it was ready to demonstrate “substantial” improvements made since its last inspection.
Doctor Care Anywhere tells Health & Protection that today it is confident in its ability to scale and meet the growing demand.
“Our model allows for flexible scheduling and access to a network of GPs who can adapt to varying levels of demand, ensuring patients are seen promptly,” it says.
“The CQC plays an important role in maintaining healthcare standards, and while there have been some concerns raised, we remain committed to working collaboratively with it.
“We believe that improvements in the system will only further strengthen the regulatory process.”
Robust capacity planning
And that commitment to head off capacity concerns, extends to other insurers.
Dr Subashini M, medical director at Aviva Health UK, says: “Our customers have access to an extensive network of GPs available to support them and we have robust capacity planning and service controls in place.
“All consultations booked via the Aviva Digital GP service during 2024 were available within 24 hours of the requested booking time and 99% within 12 hours, even when the service experienced its peak in demand.
“This gives us the confidence of the ability to respond well to demand increases.”
Steve Bryan, director of distribution and marketing at the Exeter, adds: “Value-added services like remote GP appointments are indeed surging in popularity, however service providers are equipped to satisfy the rising demand for appointments.
“We work closely with our partner Square Health to monitor the demand for services and ensure we can fulfil our commitments to our members.”
Vital services do not fall short
In any event, Debra Clark, head of wellbeing at Towergate Health & Protection, warns that however these services evolve in future, there needs to be clarity about what they can and cannot offer.
“For instance, not all virtual GP services can provide referrals to consultants to meet eligibility criteria for private medical insurance,” Clark explains.
“Other areas that need to be made clear are whether or not the virtual GP service can deal with family members or just employees, and what support they can provide to people with long-term, chronic conditions that are monitored by GPs.
“Added value services are open to criticism when expectations fall short, so it’s vital that the providers are clear about what their service can actually deliver.”